The Conversation Project was launched in 2010 with the goals of facilitating productive conversations on end-of-life care and empowering individuals to share how they wish to spend the final days of their lives.
“Doctors and hospitals don’t often have the experience, the practice, the support that they need to sit down with the patient [and] understand what’s important to them as a human being,” said Dr. Lachlan Farrow, director of palliative care programs at Beth Deaconess Medical Center and advisor to The Conversation Project. In the above video, Farrow explains that focusing solely on a patient’s medical status and discussing his or her medicine dosage, treatment schedules and therapies leaves little room for a person-centered approach.
Farrow once was asked to discuss hospice options with Thelma Botelho, a 92-year-old patient and former jazz singer with severe vascular circulation problems in her legs. Upon declining amputation, Thelma was told she did not have long to live. In Farrow’s first conversation with Thelma, he simply asked, “What would you enjoy doing on an ideal day?”
Thelma’s response was simple: singing. She was apprehensive at first and confessed, “I haven’t sung in a long time. I don’t sing anymore.” However, when Farrow noticed how Thelma’s face lit up at the thought of singing, he encouraged her to sing once again.
Although Thelma did not have long to live following her conversation with Farrow, she spent her last weeks doing what she loved.
“Doctors and hospitals don’t often have the experience, the practice, the support that they need to sit down with the patient [and] understand what’s important to them as a human being,”
“The music was right there, as vividly as it had ever been,” said Farrow. “Every time her voice started to sing, you could just see her eyes getting younger, her face getting younger and a kind of human joy returning.”
In the final stages of life, it is critical for doctors and care providers to talk to their patients as human beings. Simply asking what will make them happiest in their final days can make a world of difference.
This video originally aired as part of an Institute for Healthcare Improvement presentation at the 2014 CMS Healthcare Quality Conference.